Analysis of risk factors for dropping out of residency in orthopedics and trauma surgery

Abstract

Currently, there are no data available on dropouts from residency programs and changes of clinic in orthopedics and trauma surgery (O&T). The aim of the study is to identify personal and structural risk factors leading to dropout or switching of postgraduate training in O&T in order to present solution strategies. Anationwide anonymous online survey was conducted among residents in O&T in summer 2020. Official mail addresses were identified via the Traumanetzwerk© of the DGU and the German Hospital Federation (n = 2090). Aquestionnaire (51questions) was administered using SurveyMonkey (San Mateo, CA, USA). All residents who worked in O&T for at least 1month in the 6years prior to the start of the survey (from 07/2014) were eligible to participate. Abinary logistic regression was calculated to identify the risk factors. The significance level was p = 0.05. Of the 221 respondents, 37% switched hospital and 5% dropped out altogether. The regression revealed 3significant risk factors for switching hospitals. Living in apartnership (p = 0.029, RR: 2.823) and less than 2days of shadowing before the start of residency (p = 0.002, RR:2.4) increased the risk of switching. Operating room (OR) allocation of residents according to the training plan/status (p = 0.028, RR: 0.48) reduces the risk of switching. Significant risk factors for leaving postgraduate training could not be determined (insufficient number of cases, n = 11). Switching the hospital and residency dropouts in O&T are arelevant problem (42%). Gender has no significant influence. Tools such as longer job shadowing, as well as OR allocation according to the training plan/status can minimize the risk of switching.